DI 2 Midterm Flashcards
what is the relation b/w occipitalization and basilar invagination/impression?
occipitalization: nonsegmentation of occiput from C1= no jt space b/w C1 and occiput
basilar invagination/impression: odontoid encroachment into foramen magnum
with occipitalization can get basilar invagination/impression b/c odontoid is allowed to be closed to the foramen magnum dt lack of jt space
where do you find a posterior ponticle?
when you have partial or complete ossification of the oblique portion of the atlanto-occipital membrane
usu contains the vertebral artery and 1st cervical nerve; MC UL
what is the significance of George’s line?
George’s line: posterior vertebral body line, should be smooth, curved and an uninterrupted line
SO if it is not these things it can indicate there has been displacement of the vertebrae for some reason
why is an os odonoideum clinically significant?
normally two halves of the odontoid unite and fuse to the C2 body, in os odontoideum though the two halves do not unite and do not fuse to C2
significant b/c it is usually dt an old trauma w/nonunion
can also have instability of C2 b/c the dens is not attached to C2
What are the radiographic differences b/w congenital block vertebra and an acquired fusion of the spine?
congenital block vertebra: non segmentation of 2 adjacent segments w/decreased AP diameter, a rudimentary disc, apophyseal jt fusion and possible malformation or fusion of SPs, wasp waisted appearance
acquired fusion of the spine: normal AP diameter, normal disc, no apophyseal jt fusion, SPs are normal if not fused together, will see increased opacity where there has been fusion
what is the significance of the spinolaminar jxn and spina bifida occulta in the lateral view?
spinolaminar jxn won’t be present? or a hole will be present?
why is it common to see disc space narrowing adjacent to a limbus vertebra and/or Schmorl’s node?
Schmorl’s node: herniation of nucleus pulposus through vertebral endplate dt developmentally weak endplate, trauma or pathological process, usu asx, on lateral radiograph see focal indentation into vertebral body w/sclerotic margin, associated disc usu narrows
Limbus vertebra: nucleus pulposus herniates through ring apophysis (secondary growth area of the vertebral body), most likely dt trauma in developing spine, usu asx, narrowing b/c of herniation of disc
how can you tell whether a rib at the cerviothoracic jxn is a cervical rib or first rib?
first rib will be attached to T1
cervical rib will be attached to a cervical vertebra
what is a transitional lumbrosacral vertebra?
a lumbar vertebra that has been saralised or a sacral vertebra that has been lumbarlised (aka they have been ‘made’ into the other kind of vertebra)
if not properly dx can lead to improper procedures
name a dysplasia that can present w/tall stature and hypermobile jts? what complications may be associated w/this condition?
Marfan’s sydrome
can be associated w/hypertrophic cardiomyopathy (sudden cardiac death), congenital heart disease, cardiac abn, atrial septal defect (MC congenital heart lesion), “floppy valve” syndrome dt dilation of the ascending aorta (valvular incompetence and L-sided insufficiency)
what is the MC cause of dwarfish? what neurological condition may these individuals have that affect the legs?
achondroplasia
hereditary, AD disturbance in epiphyseal-chondroblastic growth and maturation
most significant complication in adulthood is congenital spinal stenosis which can lead to paraplegia
fragile osteopenic bones are associated w/which dysplasia?
osteogenesis imprefecta
3 major clinical criteria: blue sclera, osteoporosis w/abn fragility of the skeleton, abn dentition (need 2 out of 3 for dx)
can be congenital or tarda
what are the radiographic findings of new vs old fractures?
new= depending on timing may see nothing or may see increased opacity around area of trauma dt increased osteoblastic activity, can also see bone edema, hemorrhage, hematoma, step defects or zone of impaction (last 4 could indicate fracture is less than 2 mo old)
what are possible long bone fracture orientations?
spiral
oblique
transverse
what are the types of incomplete fractures of pediatric long bones and how do they differ?
torus= buckling of cortex greenstick= interruption of cortex w/angulation resembling a broken branch bowing= bending w/no obvious cortical defect
which is the MC type of Salter Harris fracture?
type II
what is the definition b/w a malunion and nonunion fracture
malunion= bone doesn't re-align well nonunion= bone doesn't meet and heal back together
what significant finding is demonstrated in the APOM view w/a Jefferson’s fracture
(Jefferson’s fracture= burst fracture of C1 [atlas])
classically BL anterior and posterior arch fracture of C1
dt compressive blow on the vertex of the head
on radiograph: increased lateral paraodontoid space BL, offset lateral masses of the atlas (>3 mm), prevertebral swelling, rupture of the transverse ligament (total offset > 7mm)
